Girexx: Infertility treatment in Spain, Girona

Girexx is a modern fertility clinic in Girona, Spain. They use the very latest developments and techniques available to provide childless couples with treatments and services such as IMSI (intra-cytoplasmic morphologically-selected sperm injection), egg donation, in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), ovulation induction (OI), frozen embryo transfer, preimplantation genetic diagnosis (PGD) and artificial insemination.

Infertility treatments at Girexx in Spain

In the last fifteen years there has been huge progress in our understanding of the biology of reproduction. Therapy and laboratory techniques used today are new and constantly improving. Each year we discover new data regarding the complex biological process of human reproduction at different stages, such as fertilisation and embryo implantation.

During your first visit it is necessary to perform a basic study of infertility through a complete gynaecological examination: gynaecologic ultrasound, hormone analysis, and sperm count. If you have had similar tests previously you should bring any results to avoid repetition.

With the test results the gynaecologist will have all the information needed to diagnose the causes of infertility and can offer the couple the most appropriate treatment to achieve pregnancy.

Assisted reproduction techniques

Treatment of ovulation problems - ovulation induction (OI)

This treatment is intended to resolve minor disruptions of the menstrual cycle. Hormonal treatment is administered in low doses, and ovarian stimulation achieved with ultrasound. The treatment charts the most fertile days of the patient, corresponding with the best chance of conception.

Conjugal artificial insemination (CAI)

The objective of this technique is to increase to the chances of pregnancy by stimulating the menstrual cycle and improving the characteristics of the semen. The gynaecologist stimulates the ovaries by means of vaginal ultrasound. When ovulation occurs the insemination is scheduled. That day the laboratory takes a semen sample and selects the best quality spermatozoa, which is deposited in the uterine cavity through a very simple process and without any discomfort. This can all be performed in the same consultation, immediately after which you can be discharged.

Artificial insemination by donor (AID)

This is similar to CAI, differing by use of a sample of frozen semen from the sperm bank. The sperm can is processed in the laboratory in order to select the best quality spermatozoa, which is deposited in the uterine cavity. This technique is ideal for couples suffering from:

Severe male infertility

Women who do not have a partner

Lesbian couples.

Egg donation at Girexx in Spain

When the cause of infertility is a lack of quality of eggs or the inability to obtain them, the only way to achieve pregnancy is egg donation.

The egg donation programme at Girexx began in 1983 to help couples where it is impossible to obtain eggs from the woman herself. The most common causes are:

Congenital or acquired absence of ovaries

Early menopause

Chromosomal abnormalities that are transmitted to offspring and are not candidates for PGD (Preimplantation Genetic Diagnosis)

Lack of ovarian stimulation

Repeated IVF failure

Repeated failure of embryo implantation

Patients who have had repeated abortions are not candidates for egg donation.

IMSI (intra-cytoplasmic morphologically-selected sperm injection)

IMSI is a pioneering technique performed regularly in very few centres worldwide. Up to now, the embryologist selected spermatozoa for intracitoplasmatic injection only by observing their shape and mobility. IMSI, through its digitalised amplification capacity (the size of the spermatozoon is amplified 10,000 times), provides a much more detailed image of the shape of the spermatozoa and of their nucleus morphology . By doing this, a better sperm selection can be carried out so that those that are used for the intracitoplasmatic injection are potentially better to generate good quality viable embryos.

A number of studies suggest that the pregnancy rate can increase and the miscarriage risk can be reduced if sperm are selected with IMSI.

In vitro fertilization (IVF and ICSI)

In vitro fertilisation (IVF) is indicated for couples with various causes of infertility such as

Endometriosis

Tubal blockage

Male infertility

Failed CAI treatments

Old age

Unknown infertility problems

The IVF process has several stages:

Hormonal stimulation of the ovaries

Follicular puncture

Insemination

Embryo cultivation

Transfer

The Embryos that are not used are frozen for future use in case there is no pregnancy, or to provide you with a second pregnancy.

Frozen embryo transfer

As well as providing a backup in case the first cycle of IVF is unsuccessful, this treatment may also be used by patients entering the embryo donation program. Before the transfer the woman will receive a simple hormonal treatment. The embryos are unfrozen prior to transfer and remain for a few hours in cultivation; not all embryos survive the unfreezing process. The transfer of embryos is a quick and painless process, for which there is no need for anesthesia. After the transfer the patient can be discharged after about 20 minutes, although they should take things easy for the following 12 days, when they should test positive for pregnancy.

Embryo donation

This technique is used in those patients whose cause of infertility is due to not being able to obtain viable embryos themselves. They receive frozen embryos from couples who have undergone IVF and have authorised the donation because they have satisfied their own needs.

Preimplantation genetic diagnosis (PGD)

Preimplantation genetic diagnosis is a technique that, in combination with in vitro fertilisation, allows diagnosis of genetic diseases or chromosomal imbalances in embryos before transfer.

Who can benefit from PGD?

Patients who know they are carriers of monogenic disease and who want to make sure their child is healthy

Patients suffering from translocations, inversions or other chromosomal abnormalities

Infertile patients with a history of repeated spontaneous abortions

Patients with repeated implantation failure in previous cycles of IVF

IVF patients over 35 with more than 5 repeated failures of implantation

Patients who know they are carriers of some oncogene, who want to ensure that their children are not carriers (BRCA I, II, etc)

How is PGD performed?

After undergoing IVF, PGD is performed a biopsy on the embryo when it is between 7 and 8 cells. A cell is removed and analyzed to determine whether or not it possesses the genetic alteration that is being sought.

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